Basic Information
| Provider Information | |||||||||
| NPI: | 1205407442 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | EARL | ||||||||
| MiddleName: | ANTONIO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5143 W WOODMILL DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198084067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029998426 | ||||||||
| FaxNumber: | 3029998761 | ||||||||
| Practice Location | |||||||||
| Address1: | 5143 W WOODMILL DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198084067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029998426 | ||||||||
| FaxNumber: | 3029998761 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2021 | ||||||||
| LastUpdateDate: | 07/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | AN-0024801 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.